Category Archives: Coronavirus

UPMC planning to ramp up elective surgeries despite state ban

Posted on by • Posted in Cash, Cash Reserves, Cash-Flow Improvements, Coronavirus, Crisis, Crisis Management, Elective Procedures, Elective Surgery, Health Policy, Health System, Hospital, Hospital Industry, Infection Control, Infectious Virus, Net Income, Operating Expenses, Operating Income, Operating Margin, Operating Performance, Operating Revenue, Pandemic • Leave a comment

https://www.beckershospitalreview.com/patient-flow/upmc-planning-to-ramp-up-elective-surgeries-despite-state-ban.html?utm_medium=email

UPMC to Ensure Patients Not Caught in Middle of Out-Of-Network ...

Within six weeks, UPMC plans to return elective surgeries to the level they were before the coronavirus pandemic shut them down, despite a ban on the surgeries ordered by Pennsylvania Gov. Tom Wolf in March, the Pittsburgh Post-Gazette reports.

The ban prohibiting elective surgeries statewide took effect in March, and state health department officials confirmed to the Post-Gazette that the ban is still in place. But the publication obtained a letter sent to UPMC surgeons dated April 15 that shows it making plans to ramp up elective surgeries.

The letter gives surgeons advice on how to justify the procedures, telling them to use terms such as “urgent,” “cancer” and “relief from suffering,” the Post-Gazette reports.

A UPMC spokesman said April 20 that the 40-hospital system believes it can perform elective procedures safely, according to the report. The spokesman also said that new CMS guidance offered healthcare organizations flexibility with regard to providing patients the care they need for nonurgent conditions.

“In the current environment, with proper protection and precautions, we believe that we can soon begin to treat patients who postponed needed treatments and procedures,” the spokesman said in a statement to the Post-Gazette.

A key driver for boosting the number of elective surgeries will be technology that received emergency FDA clearance March 29. That technology allows face masks used by clinicians during COVID-19 care to be sterilized for reuse up to 20 times, the Post-Gazette reports.

UPMC has been piloting the technology and plans to roll out its use to all surgical sites, a handout from an employee meeting April 16 shows.

The ban on elective surgeries, currently in place in 35 states, is hurting hospital finances. The Hospital and Healthsystem Association of Pennsylvania released a report April 20 that shows the pandemic could take a $10 billion toll on hospitals in the state.

If UPMC moves forward with its plans, it would be the first hospital in the state to return to performing elective surgery procedures.

 

 

 

 

Standing Up to a Tidal Wave of Ignorance, Fear and Abuse

Posted on by • Posted in 2020 Election Issues, Abuse, Core Values, Coronavirus, Crisis, Crisis Management, Desperation, Fear, Front Lines, Health Policy, Healthcare Providers, Ignorant, Infection Control, Infectious Virus, Nurses, Pandemic, Physician, Public Health, Public Safety, Quarantine, Social Distancing • Leave a comment

Image may contain: one or more people, people standing, sky, tree and outdoor

Today I stood with some of my fellow nurses and faced a tidal wave of ignorance, fear, and abuse.

I was mocked. I was called more names than I can remember. I was told I was ignorant, unintelligent, and compassionless. I was accused of being a fake nurse, a paid protester, a fraud. I was told I was nothing. I had cigarette smoke blown in my face. I was sexually harassed. A few times, I was surrounded on all sides by multiple people yelling at me.

Desperation and fear bring out the worst in people. I will admit, I cried a bit. How could I not in the face of so much hate?

But I when I did, I was crying for my fellow healthcare workers on the front lines, who are working their asses off fighting this illness, who are being put at worse risk because of the lack of essential protective equipment in this country. I cried for those who have left their families behind to go help where the situation is most dire. I cried for those who have died and will continue to die, after working their hardest to help those who needed them.

I cried for every protester who doesn’t know how they are going to make ends meet, that are afraid for their businesses, their jobs, their homes, and their lives. I cried for every American who has received less than adequate help from the government, who felt like this is the only way for them to get the resources they need, and who have been failed by our president who has not implemented the measures required to help and protect our most vulnerable people.

I cried for every person at this protest that will inevitably get sick, and increase the spread in our state when we had been doing a pretty good job of flattening the curve and delaying the spread of covid-19 in Arizona. I cried for every person who will be infected by those that contracted the disease today.

But more important than the few tears I shed today, was that I stood strong for what is right.

I stood for using science, not feelings, to make important decisions in a pandemic. I stood for the healthcare workers who are going to keep working our hardest to help heal the sick, whether they appreciate it or not. I stood for those who couldn’t. I stood for the lives we have lost, many unnecessarily, to this virus. I stood strong and looked every protester fighting to open Arizona in the eye, so they would have to stare into the face of some of the individuals they are hurting with their ignorance. My hands cramped up from standing in this position so long, but I kept standing until everything died down.

And I will keep standing.

 

The Inside Story Of How The Bay Area Got Ahead Of The COVID-19 Crisis

Posted on by • Posted in 2020 Election Issues, Camaraderie, Clinical Testing, Cooperation, Coronavirus, Crisis, Crisis Management, Health Policy, Infection Control, Infectious Virus, Leadership, Leadership Alignment, Leadership Cares, Leadership Culture, Leadership Integrity, Leadership Trust, Mortality, Pandemic, Public Health, Public Safety, Quarantine, Social Distancing, Trust, Truth, Vaccination, Vaccine • Leave a comment

https://khn.org/news/the-inside-story-of-how-the-bay-area-got-ahead-of-the-covid-19-crisis/

The Inside Story Of How The Bay Area Got Ahead Of The COVID-19 ...

Sunday was supposed to be a rare day off for Dr. Tomás Aragón after weeks of working around-the-clock.

Instead, the San Francisco public health officer was jolted awake by an urgent 7:39 a.m. text message from his boss.

“Can you set up a call with San Mateo and Santa Clara health officers this a.m., so we can discuss us all getting on the same page this week with aggressive actions, thanks,” said the message from Dr. Grant Colfax, director of San Francisco’s Department of Public Health.

“Will do, getting up now,” Aragón responded.

It was March 15, two days before St. Patrick’s Day, a heavy partying holiday and nightmare scenario for public health officials.

The novel coronavirus was spreading stealthily across the San Francisco Bay Area and public health officials were alarmed by the explosion of deaths in Italy and elsewhere around the globe. Silicon Valley would be next, case counts indicated.

Until then, they had primarily focused on banning mass gatherings. But they knew more had to be done — and wanted to present a united front.

Within a few hours of the text, Bay Area public health leaders jumped on a series of calls to debate options, including the most dramatic — a lockdown order that would shutter businesses, isolate families and force millions of residents to stay home.

They decided they had no choice. And they were able to move swiftly because they had a secret weapon: a decades-long alliance seeded in the early days of the AIDS epidemic that shields them from political blowback when they need to make difficult decisions.

Together, they would issue the nation’s first stay-at-home order, likely saving thousands of lives and charting the course for much of the country. Three days later, Gov. Gavin Newsom followed with his own order for California. New York came next, as have dozens of states since.

“This was one exhausting and difficult day for all of us,” Aragón later wrote in his journal. “We all wish we did not have to do this.”

Now, officials nationwide are weighing how to lift isolation orders as the rate of COVID-19 transmission slows — and protests against the orders mount. The Bay Area is again poised to lead, but with a warning: All of this could be for naught if it isn’t done right.

The coalition of county public health officers didn’t set out to lock down the Bay Area that fateful Sunday morning in mid-March. But as they discussed the exponential increase in Santa Clara County cases, where the hospitals were becoming overwhelmed by infected patients falling ever sicker, what they needed to do “started to crystalize,” said Dr. Sara Cody, the county’s public health officer.

“It felt huge to me,” she recalled, “because I knew how disruptive it would be.”

Elsewhere in the region, diagnosed cases were sparse. But decades of experience had shown the health officers that while they represent different jurisdictions, they are one region when it comes to infectious diseases. “We knew that it would be a matter of time before that was our experience,” said Dr. Matt Willis, Marin County’s public health officer, who contracted COVID-19 days later.

Cody told her colleagues that Italy was under siege, and her county was just two weeks away from a similar fate. If she could have locked down sooner, she told them, she would have.

“That was compelling,” said Dr. Lisa Hernandez, the public health officer for the city of Berkeley, which had not yet recorded any cases of community transmission. “We knew there was going to be St. Patrick’s Day parades and celebrations, so the timing was critical.”

Dr. Scott Morrow, California’s longest-serving public health officer, who heads operations in San Mateo County, said he also felt the urgency. “We thought, ‘Yes, the clock is ticking,’” he recalled.

County health officers in California have immense power to act independently in the interest of public health, including the authority to issue legally binding directives. They don’t need permission from the governor or mayors or county supervisors to act.

Even for this group, though, with all its collective strength, telling millions of Californians to shelter in place seemed risky at first. But the health officers involved had grown to trust one another, even if they don’t always see eye to eye.

For instance, they currently disagree on whether to require residents to wear face coverings. Some counties, including San Francisco and Marin, are requiring them in public, while others, like Santa Clara, are not.

On the first Sunday morning call, Aragón floated the idea of developing a coordinated recommendation that Bay Area residents stay at home. By the next confab, Cody, Santa Clara County’s health official, made the case that for social distancing to work, it had to be an order.

“Sara Cody was the courageous leader!” Aragón later wrote in his journal.

So forceful a move can be unpopular, but evidence shows it can also be the most effective, in the absence of treatment or a vaccine. “Here’s the rub on these methods — they only work if you do it really early,” said Dr. Howard Markel, a medical historian at the University of Michigan and an expert on the 1918 flu pandemic.

“When you do a quarantine, you stop the commerce, you stop the flow of money,” he said. “But on the other side of that are those whose lives are saved.”

This isn’t the group’s first pandemic. The alliance, formally called the Association of Bay Area Health Officials, was born in 1985 in the early days of the AIDS epidemic.

Dr. David Werdegar, who became health officer for San Francisco that year, was analyzing AIDS data for surrounding counties and asked their health officers to join him for dinner at Jack’s, an old bordello-turned-political hangout in the city that has since shuttered.

Most of the infectious disease research was happening in San Francisco at the time, but HIV was spreading, and one city couldn’t fight it alone.

“It was important that we share all the information we had,” said Werdegar, now in his 80s and retired.

Dr. Robert Melton, a former Monterey County health officer, said that working for nearly two decades with Bay Area public health giants taught him tremendous lessons. “Camaraderie is important in maintaining the energy to be able to focus on the common good, through good and bad,” he said.

That close-knit relationship among the 13 health officers — representing counties stretching across a large swath of Northern California from Napa to Monterey — continues to this day. Collectively, their public health actions touch about 8.5 million people.

They meet monthly and communicate regularly on Slack, a messaging app. Their diverse backgrounds and expertise, especially in an era of funding cuts, provide a deep well of public health knowledge from which to draw. Together, the group has joined forces to combat youth vaping, air pollution and measles outbreaks.

And they have also tackled various influenza scares, which is why they had an emergency response blueprint at the ready when cases of what would later be called COVID-19 first cropped up in Wuhan, China.

“We spent a couple years as a region thinking about pandemic planning, and that really helped us come a long way thinking about these policies for COVID-19,” said Dr. Erica Pan, the interim health officer for Alameda County.

So when they jumped on the call that Sunday, they were already in mid-conversation about how to respond. They brought their lawyers and, working into the predawn hours, translated their lockdown plan into legalese, one that would be enforceable with fines and misdemeanor charges.

They would make prime-time announcements across the region the next day, alongside elected officials. “This is not the moment for half-measures,” said San Jose Mayor Sam Liccardo. “History won’t forgive us for waiting an hour more.”

At first, the stay-at-home order applied just to the “Big Seven” counties surrounding the San Francisco Bay, whose officers peeled off from the larger group to issue it first. They shared their model ordinance with the others, who quickly followed.

Dr. Gail Newel, an OB-GYN and Santa Cruz County’s health officer, is not an infectious disease expert. She has relied heavily on the group’s expertise throughout her career, and especially now.

“It’s this incredible bank of knowledge and wisdom and experience that’s freely shared among the members,” she said. “And the whole Bay Area benefits by that shared knowledge bank.”

Roughly one month after they made the unprecedented decision to close the local economy, the risk seems to have paid off. It will be years before researchers have fully analyzed its impact, but officials across the Bay Area are cautiously optimistic. Others haven’t been so lucky.

Though there are important differences between the two regions, New York City, which issued a stay-at-home order four days after the Bay Area, saw its hospitals completely overwhelmed and had recorded more than 14,600 deaths as of Monday.

By comparison, the counties represented by the alliance have documented more than 215 deaths and hospitals haven’t been overtaken by a surge. In fact, hospitals brought online specifically to accommodate an overflow of patients are sitting largely empty.

Even within California, communities that waited to issue lockdown orders have emerged as COVID-19 hot spots, including Los Angeles, where Mayor Eric Garcetti followed suit three days after the Bay Area.

Internally, some of the Bay Area health officials have wondered if they made the right call. But “anytime I have any doubt, I just read another news report from New York or Detroit or New Orleans,” said Dr. Chris Farnitano, Contra Costa County’s health officer.

And the close-knit band is already undertaking its next task: reopening the economy without causing another spike in cases.

Before the orders are lifted, the officials say there must be rapid, widespread testing across the population. They want to hire disease investigators by the hundreds, if not the thousands, to trace the virus and quarantine those who have been infected. And until there is a vaccine, they may ask people to wear masks in public and continue social distancing, even in bars, restaurants and schools when they reopen.

“I was concerned that we might get a lot of resistance and it might get interpreted as alarmist and overreach,” said Marin County’s Willis. “Time has shown that it was really a vital step to take when we took it.”

 

 

 

 

Health Care Workers Stand Up To People Protesting Stay-At-Home Orders

Posted on by • Posted in 2020 Election Issues, Core Values, Coronavirus, Crisis, Crisis Management, Economic Crisis, Economy, Freedom, Front Lines, Health Policy, Healthcare Providers, Infection Control, Infectious Virus, Pandemic, Partisanship, Public Health, Public Safety, Quarantine, Social Distancing, Unemployment, Unemployment Insurance • Leave a comment

https://nowthisnews.com/news/health-care-workers-stand-up-to-people-protesting-stay-at-home-orders

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Remarkable scene at 12th and Grant, where two healthcare workers from a Denver-area hospital — they declined to say which or give their names — are standing in the crosswalk during red lights as a “reminder,” they say, of why shutdown measures are in place.

Two health care workers blocked a parade of protesters in Denver, Colorado on Sunday, who were storming the capitol to protest the state’s stay-at-home order.

Powerful images and videos of the standoff were widely shared on social media of the two unidentified people wearing scrubs and N95 masks, standing in a crosswalk blocking protesters’ vehicles. The two were identified as health care workers by photographers on the scene. 

One video shared by Twitter user Marc Zenn, captured cars lined up and beeping their horns at the two medical workers, with a woman hanging out of her vehicle’s window shouting “Go to China if you want communism. Go to China,” and “You get to go to work, why can’t we?”

View image on Twitter

They say they’ve been treating COVID patients for weeks. Today most of the people driving by have been “very aggressive,” they say. I’ve been standing here for a few minutes and already seen two people get in their faces.

Hundreds of people showed up on foot and in their vehicles for two separate protests in Colorado’s capitol on Sunday. The protests were reportedly planned by ReOpen Colorado and “various Libertarian parties,” according to a local Denver news outlet. People attending the march were shown carrying American flags, “Don’t Tread on Me” flags, and signs about reopening businesses and schools.

“Coloradans have a first amendment right to protest and to free speech, and the Governor hopes that they are using social distancing and staying safe,” Colorado Gov. Jared Polis’ office said in a statement. “No one wants to reopen Colorado businesses and lift these restrictions more than the Governor, but in order to do that, Coloradans have to stay home as much as possible during this critical period, wear masks and wash their hands regularly to slow the spread of this deadly virus.”

As of Monday morning, Colorado has more than 9,700 cases of COVID-19, leading to at least 420 deaths, according to the Johns Hopkins coronavirus tracker. The state of Colorado is set to continue its stay-at-home order until at least April 26, to slow the transmission of the virus.  

Colorado isn’t the only state where protesters are demonstrating against their government’s stay-at-home orders—Several other states held protests over the weekend including Utah, Idaho, and Washington state. Last week, parts of Michigan, New York, Ohio, Virginia, North Carolina, and others also saw a wave of demonstrators. 

President Trump encouraged the protesters last week during his Friday press briefing and in tweets which said to “liberate” multiple states holding protests.

In a Politico poll, 81% of Americans agreed we “should continue to social distance for as long as is needed to curb the spread of coronavirus, even if it means continued damage to the economy.” An NBC News poll found that 60% of responders agreed with keeping at-home restrictions.

 

 

Current State of the Union

Posted on by • Posted in 2020 Election Issues, Core Values, Coronavirus, Crisis, Crisis Management, Economic Crisis, Economy, Health Policy, Infection Control, Infectious Virus, Pandemic, Partisanship, Public Health, Public Safety, Social Distancing, Values • Leave a comment

https://www.buzzfeednews.com/article/gabrielsanchez/huge-crowds-protest-coronavirus-trump-coronavirus-pandemic?fbclid=IwAR0abgB9Wpv2WAOhNgdYhQgNU6W6h1NnqoVcxxye4QTRBwQaSEsxzeIXyho

These Pictures Show Crowds Protesting Against Coronavirus Lockdowns At State Capitols

Conservative demonstrators gathered at the capitol buildings of Michigan, Kentucky, and North Carolina to protest against stay-at-home orders during a pandemic that has already left more than 26,000 Americans dead.

 

What is work sharing and how can it help the labor market?

Posted on by • Posted in Coronavirus, Crisis, Crisis Management, Employee Benefits, Employee Furlough, Employee Layoffs, Employer-Based Health Insurance, Health System, Hospital, Hospital Industry, Talent Management, The CARES Act, Unemployment, Unemployment Insurance, Work Sharing • Leave a comment

https://www.brookings.edu/blog/up-front/2020/04/16/what-is-work-sharing-and-how-can-it-help-the-labor-market/?utm_campaign=Brookings%20Brief&utm_source=hs_email&utm_medium=email&utm_content=86505163

What is work sharing and how can it help the labor market?

When economic conditions worsen, as they did beginning in March 2020 because of the COVID-19 pandemic, employers often respond by laying off their employees. This can lead to very undesirable outcomes for society at large. Research shows that losing a job often causes decreased long-term earnings, health problems, and other adverse outcomes, the effects of which can last generations (Abraham and Houseman 2014). Layoffs create future costs for employers as well—once demand picks back up, firms will have to expend valuable resources on significant search, hiring, and training costs.

The U.S. unemployment insurance (UI) system can help. Its core function is to replace some of the earnings of workers who have lost their jobs, helping them to stay afloat during tough economic times. But the UI system can also support workers and employers as they reduce, rather than eliminate, employees’ work hours.

WHAT IS WORK SHARING?

A program called work sharing, or short-time compensation, encourages employers to temporarily reduce the hours of their employees rather than lay them off during an economic downturn. Work sharing allows employers to keep their skilled workforce and reestablish a full-time schedule when economic conditions improve. With this approach, employees continue to be paid for the hours they work, collecting pro-rated unemployment benefits that help cover the work hours they lose. For example, employers could reduce everyone’s hours by 20 percent and employees would qualify for 20 percent of the weekly unemployment benefit amount.

In a Hamilton Project proposal, economists Katharine Abraham and Susan Houseman described reforms that would facilitate the use of work sharing. The importance of these reforms for addressing the current economic downturn was discussed further in a recent webcast titled, “Unemployment Insurance during the COVID-19 Pandemic: Reducing the Impact of this Economic Downturn.”

WHAT IS THE RATIONALE FOR WORK SHARING? HOW MANY JOBS COULD IT SAVE?

Work sharing provides employers a way to respond to a decrease in demand by cutting back on hours rather than laying workers off. This approach maintains employer-employee connections, minimizing layoffs and supporting workers who have their hours reduced. Work sharing can be particularly helpful when the drop in demand is expected to be temporary, as many think likely for this pandemic-caused recession.

The value of preserving relationships between employers and employees is twofold. First, it can avoid huge spikes in permanent job losses that are financially ruinous for many families. Workers continue their employment, albeit with reduced hours, and avoid many of the damaging effects of losing a job (like loss of health insurance coverage). Second, both employers and workers will avoid costly search, hiring, and training once demand eventually picks back up.

Throughout the Great Recession, when only 17 states offered the option, use of work-sharing was very limited. Abraham and Houseman estimate that if work sharing had been available for the entire country during the Great Recession—and take-up rates had been similar to our European counterparts—work-sharing programs could have saved up to 1 million jobs, or 1 in 8 of the net jobs that were lost during the Great Recession.

HOW WIDESPREAD ARE WORK-SHARING PROGRAMS?

Today, 26 states, covering nearly 70 percent of the workforce, have operational work-sharing programs in place. But work sharing has been little used in the earliest days of this recession. As of the week ending in March 28, just 0.3 percent of the more than 8.2 million people claiming UI benefits received work-sharing benefits.

To expand coverage, Abraham and Houseman propose that Congress pass legislation that requires states to have a work-sharing program as a part of their UI system to participate in the federal–state UI system. Further, in order to encourage state take-up, they propose that the U.S. Department of Labor modify its funding formula to more accurately fund state administrative burdens associated with implementing and promoting work-sharing programs.

WHAT ELSE CAN BE DONE TO MAKE IT EASY FOR EMPLOYERS TO USE THE PROGRAM?

First, states could look for opportunities to expedite the process of starting up a work-sharing plan and paying benefits. Second, states could remove policies that tend to discourage the use of work sharing and push employers toward layoffs. For example, some states bar employers who have heavily used the UI system in the past from participating in work-sharing programs. Additionally, some states impose higher effective UI tax rates on employers who choose work-share programs than if they laid off their workers. Designed to prevent abuse of the UI system, these policies may discourage work sharing, especially during downturns. Abraham and Houseman recommend that Congress add a prohibition against the use of these policies to the existing criteria for state eligibility to participate in the federal–state UI system.

HOW CAN WORK-SHARING PROGRAMS BE FURTHER INCORPORATED INTO THE EXISTING UI SYSTEM?

Under current law, sharp increases in a state’s unemployment rate trigger extensions to the benefits available in that state; the federal government covers half the cost of those extensions. That same federal-state program could enhance the use of work sharing. Abraham and Houseman propose that the federal government cover half the cost of work-sharing programs when UI extended benefits are triggered in a state. As explained below, Congress has recently gone beyond this proposal, but only on a temporary basis.

HOW IS WORK SHARING ADDRESSED IN THE CORONAVIRUS AID, RELIEF, AND ECONOMIC SECURITY ACT (CARES ACT)?

The CARES Act, signed into law on March 25, 2020, encourages states and employers to use work-sharing programs. The federal government will reimburse 100 percent of the cost of short-time compensation benefits paid in states that have work-sharing programs in place. For those states that do not have a work-sharing program, the CARES act includes funds to pay for short-time benefits at a 50 percent federal coverage rate. Finally, the CARES Act allocates grant funding for states to promote and improve the implementation and administration of work-sharing programs.

 

 

 

Trump, Head of Government, Leans Into Antigovernment Message

Posted on by • Posted in 2020 Election Issues, Accountability, Coronavirus, Crisis, Crisis Management, Economy, Failure, Health Policy, Indecision, Infection Control, Infectious Virus, Leadership, Leadership Trust, Pandemic, Partisanship, Public Health, Public Safety, Responsibility, Social Distancing, Trust, Truth, Uncertainty • Leave a comment

Trump, Head of Government, Leans Into Antigovernment Message

With his poll numbers fading after a rally-around-the-leader bump, the president is stoking protests against stay-at-home orders.

First he was the self-described “wartime president.” Then he trumpeted the “total” authority of the federal government. But in the past few days, President Trump has nurtured protests against state-issued stay-at-home orders aimed at curtailing the spread of the coronavirus.

Hurtling from one position to another is consistent with Mr. Trump’s approach to the presidency over the past three years. Even when external pressures and stresses appear to change the dynamics that the country is facing, Mr. Trump remains unbowed, altering his approach for a day or two, only to return to nursing grievances.

Not even the president’s re-election campaign can harness him: His team is often reactive to his moods and whims, trying but not always succeeding in steering him in a particular direction. Now, with Mr. Trump’s poll numbers falling after a rally-around-the-leader bump, he is road-testing a new turn on a familiar theme — veering into messages aimed at appealing to Americans whose lives have been disrupted by the legally enforceable stay-at-home orders.

Whether his latest theme will be effective for him is an open question: In an NBC/Wall Street Journal poll released on Sunday, just 36 percent of voters said they generally trusted what Mr. Trump says about the coronavirus.

But the president, who ran as an insurgent in 2016, is most comfortable raging against the machine of government, even when he is the one running the country. And while the coronavirus is in every state in the union, it is heavily affecting minority and low-income communities.

So when Mr. Trump on Friday tweeted “LIBERATE,” his all-capitalized exhortations against strict orders in specific states — including Michigan — were in keeping with how he ran in 2016: saying things that seem contradictory, like pledging to work with governors and then urging people to “liberate” their states, and leaving it to his audiences to hear what they want to hear in his words.

For instance, Mr. Trump did not take the opportunity to more forcefully encourage the protesters when he spoke with reporters on Friday.

“These are people expressing their views,” Mr. Trump said. “They seem to be very responsible people to me.” But he said he thought the protesters had been treated “rough.”

In a webcast with Students for Trump on Friday, a conservative activist and Trump ally, Charlie Kirk, echoed the message, encouraging a “peaceful rebellion against governors” in states like Michigan, according to ABC News.

On Fox News, where many of the opinion hosts are aligned with Mr. Trump and which he watches closely, there have also been discussions of such protests. And Mr. Trump has heard from conservative allies who have said they think he is straying from his base of supporters in recent weeks.

So far, the protests have been relatively small and scattershot, organized by conservative-leaning groups with some organic attendance. It remains to be seen if they will be durable.

But Mr. Trump’s show of affinity for such actions is in keeping with his fomenting of voter anger at the establishment in 2016, a key to his success then — and his fallback position during uncertain moments ever since.

In the case of the state-issued orders, Mr. Trump’s advisers say his criticism of certain places is appropriate.

Stephen Moore, a former adviser to Mr. Trump and an economist with FreedomWorks, an organization that promotes limited government, said he thought protesters ought to be wearing masks and protecting themselves. But, he added, “the people who are doing the protest, for the most part, these are the ‘deplorables,’ they’re largely Trump supporters, but not only Trump supporters.”

On Sunday, Mr. Trump again praised the protesters. “I have never seen so many American flags,” he said.

But Mr. Trump’s advisers are divided about the wisdom of encouraging the protests. At some of them, Gov. Gretchen Whitmer of Michigan, a Democrat, has been compared to Adolf Hitler. At least one protester had a sign featuring a swastika.

One adviser said privately that if someone were to be injured at the protests — or if anyone contracted the coronavirus at large events where people were not wearing masks — there would be potential political risk for the president.

But two other people close to the president, who asked for anonymity in order to speak candidly, said they thought the protests could be politically helpful to Mr. Trump, while acknowledging there might be public health risks.

One of those people said that in much of the country, where the numbers of coronavirus cases and deaths are not as high as in places like New York, New Jersey, California and Washington State, anger is growing over the economic losses that have come with the stringent social-distancing restrictions.

And some states are already preparing to restart their economies. Ohio, where Gov. Mike DeWine, a Republican, took early actions against the spread of the virus, is planning a staged reopening beginning on May 1.

Still, as Mr. Trump did throughout 2016, as when he said “torture works” and then walked back that statement a short time later, or when he advocated bombing the Middle East while denouncing lengthy foreign engagements, he has long taken various sides of the same issue.

Mobilizing anger and mistrust toward the government was a crucial factor for Mr. Trump in the last presidential election. And for many months he has been looking for ways to contrast himself with former Vice President Joseph R. Biden Jr., the presumptive Democratic presidential nominee and a Washington lifer.

The problem? Mr. Trump is now president, and disowning responsibility for his administration’s slow and problem-plagued response to the coronavirus could prove difficult. And protests can be an unpredictable factor, particularly at a moment of economic unrest.

Vice President Mike Pence, asked on NBC’s “Meet the Press” about the president’s tweets urging people to “liberate” states, demurred.

“The American people know that no one in America wants to reopen this country more than President Donald Trump,” Mr. Pence said, “and on Thursday the president directed us to lay out guidelines for when and how states could responsibly do that.”

“And in the president’s tweets and public statements, I can assure you, he’s going to continue to encourage governors to find ways to safely and responsibly let America go back to work,” he said.

With the political campaign halted, Mr. Trump’s advisers have seen an advantage in the frozen-in-time state of the race. Mr. Biden has struggled to fund-raise or even to get daily attention in the news cycle.

But Mr. Trump himself has seemed at sea, according to people close to him, uncertain of how to proceed. His approval numbers in his campaign polling have settled back to a level consistent with before the coronavirus, according to multiple people familiar with the data.

His campaign polling has shown that focusing on criticizing China, in contrast with Mr. Biden, moves voters toward Mr. Trump, according to a Republican who has seen it.

“Trump finally fired the first shot” with his more aggressive stance toward the Chinese government and its leader, Xi Jinping, said Stephen K. Bannon, Mr. Trump’s former chief strategist. “Xi is put on notice that the death, economic carnage and agony is his and his alone,” Mr. Bannon said. “Only question now: What is America’s president prepared to do about it?”

Mr. Trump’s campaign manager, Brad Parscale, has advocated messages that contrast Mr. Trump with Mr. Biden on a number of fronts, including China.

But inside and outside the White House, other advisers to Mr. Trump see an advantage in focusing attention on the presidency.

Kellyanne Conway, the White House counselor, has argued in West Wing discussions that there is a time to focus on China, but that for now, the president should embrace commander-in-chief moments amid the crisis.

Chris Christie, the former governor of New Jersey and a friend of Mr. Trump’s, said on ABC’s “This Week” that he did not think ads criticizing Mr. Biden on China were the right approach for now.

Ultimately, Mr. Trump’s advisers said, most of his team is aware that it can try to drive down Mr. Biden’s poll numbers, but that no matter what tactics it deploys now, the president’s future will most likely depend on whether the economy is improving in the fall and whether the virus’s spread has been mitigated. Those things will remain unknown for months.

“This is going to be a referendum,” Mr. Christie said, “on whether people think, when we get to October, whether or not he handled this crisis in a way that helped the American people, protected lives and moved us forward.”

 

 

 

 

Governors Reject Pence’s Claim on Virus Testing

Posted on by • Posted in 2020 Election Issues, Clinical Testing, Core Values, Coronavirus, Crisis, Crisis Management, Health Policy, Infection Control, Infectious Virus, Mislead, Misleading, Pandemic, Public Health, Public Safety, Social Distancing, Supply Chain • Leave a comment

Coronavirus and Reopening: Governors Say They Lack Tests as Trump ...

Democratic and Republican governors bristled at claims from the Trump administration that the supply of tests was adequate to move firmly toward reopening the country.

Governors facing growing pressure to revive economies decimated by the coronavirus said on Sunday that a shortage of tests was among the most significant hurdles in the way of lifting restrictions in their states.

“We are fighting a biological war,” Gov. Ralph Northam of Virginia said on “State of the Union” on CNN. “We have been asked as governors to fight that war without the supplies we need.”

In interviews on Sunday morning talk shows, Mr. Northam was among the governors who said they needed the swabs and reagents required for the test, and urged federal officials to help them get those supplies.

The governors bristled at claims from the Trump administration that the supply of tests was adequate. On NBC’s “Meet the Press,” Vice President Mike Pence said “there is a sufficient capacity of testing across the country today for any state in America” to go to the first of three phases that the administration says are needed for the country to emerge from the coronavirus shutdown.

Mr. Northam, a Democrat, called Mr. Pence’s claim “delusional.” In Michigan, Gov. Gretchen ​Whitmer, also a Democrat, said the state could perform “double or triple” the number of tests it is doing now “if we had the swabs or reagents.” ​Gov. Larry Hogan​ of Maryland, a Republican, said that it was “absolutely false” to claim that governors were not acting aggressively enough to pursue as much testing as possible.

“It’s not accurate to say there’s plenty of testing out there, and the governors should just get it done,” Mr. Hogan ​said​ on “State of the Union​.​”​ “That’s just not being straightforward.”

The conflicting messages come as the debate over how and when to reopen the economy has intensified. President Trump on Saturday expressed his confidence in the nation’s testing capability and said some governors have “gotten carried away,” while state officials said they feared moving too early could cause the virus to flare again.

“As tough as this moment is,” Ms. Whitmer said in an interview with CNN, “it would be devastating to have a second wave.”

In a news conference on Sunday evening, Mr. Trump expressed his confidence in the federal response, including his administration’s relationship with governors and the capacity for testing.

Mr. Trump said the administration was preparing to use the Defense Production Act to compel one U.S. facility to increase production of test swabs by over 20 million per month. The announcement came after he defended his response to the accusations that there was an insufficient amount of testing to justify reopening the economy any time soon.

“You’ll have so many swabs you won’t know what to do with them,” Mr. Trump said.

Officials at every level have faced increasingly competing pressures, balancing maintaining stay-at-home orders against the exasperation and economic toll they are producing. On Saturday and Sunday, modest protests took place in several cities across the country, where demonstrators flouted social distancing rules as they demanded that restrictions be relaxed.

Yet there was also a widespread sense that much of the public understood the governors’ concerns and shared them. Nearly 60 percent of American voters said they were worried that measures would be relaxed too soon, causing deaths to rise, according to a new poll from NBC News and The Wall Street Journal.

Officials in various states said they had started staging plans for reopening their economies and were working in concert with neighboring states in determining when to lift restrictions.

In South Carolina, Gov. Henry McMaster said that he had spoken with the governors of other southeastern states, including Florida and Tennessee. “Told them South Carolina was ready,” Mr. McMaster, a Republican, said on Twitter on Saturday.

On Sunday, governors from across the Northeast, including New York, New Jersey, Connecticut and Pennsylvania, said they were creating a regional council focused on restoring the economy and addressing unemployment.

Still, many governors, including Andrew M. Cuomo of New York and Philip D. Murphy of New Jersey, said that testing still needed to be ramped up considerably before moving forward, and that they needed federal help to do so.

There are currently about 150,000 diagnostic tests conducted each day, according to the Covid Tracking Project. Researchers at Harvard estimated last week that in order to ease restrictions, the nation needed to at least triple that pace of testing.

Dr. Deborah Birx, the coronavirus response coordinator for the White House, also pushed back against criticism that not enough people were being tested, saying that not every community required high levels of testing and that tens of thousands of test results were probably not being reported.

“We need to predict community by community the testing that is needed,” Dr. Birx said Sunday on CBS’s “Face the Nation​.” “Each will have a different testing need, and that’s what we’re calculating now.”

On the ABC program “This Week,” Dr. Birx said she thought statistics on testing were incomplete: “When you look at the number of cases that have been diagnosed, you realize that there’s probably 30,000 to 50,000 additional tests being done that aren’t being reported right now.”

Shortages of supplies have restricted the pace of testing, according to commercial laboratories. Dr. Birx said that a team at Walter Reed National Military Medical Center was calling hundreds of labs around the country to determine exactly what supplies they need “to turn on full capacity, which we believe will double the number of tests that are available for Americans.”

In the news conference on Saturday, Mr. Trump said the criticism of the administration was driven by Democrats. “Unfortunately, some partisan voices are trying to politicize the issue of testing,” he said.

Yet, Gov. Jay Inslee of Washington noted that governors from both parties had been among those voicing frustration over a lack of federal support with testing. He also criticized what he saw as a discordant message from Mr. Trump, which, he argued, undermined governors’ stay-at-home orders and inspired “people to ignore things that actually can save their lives.”

“These orders actually are the law of these states,” Mr. Inslee, a Democrat, said in an interview with “This Week.” He added: “And, again, these are not just Democrats. These are Republican-led states as well. To have an American president to encourage people to violate the law, I can’t remember any time during my time in America where we have seen such a thing.”

Now, with states transitioning away from addressing the peak of the pandemic, governors stand to face a difficult landscape to navigate.

Governors across the political spectrum have stepped into the spotlight during the coronavirus crisis, holding daily news briefings and going back and forth with the president. But if they drew praise for taking quick action to protect public health, taking responsibility for when and how to reopen could prove far more politically perilous, said Ray Scheppach, a public policy professor at the University of Virginia and a former longtime executive director of the National Governors Association.

“That is one of the reasons you’re seeing groups of governors and states get together,” he said, noting the alliances made by clusters of governors around the country.

“Doing something with the surrounding states does give you a certain amount of political cover,” both with constituents and the White House, Professor Scheppach said. “They don’t want to get pushed around by this president and they are stronger in a group.”

Having claimed responsibility for reopening the country, governors are now offering hesitant timelines. Offering no date for reopening may leave people feeling despondent at a time when “people need more certainty as opposed to less,” Professor Scheppach said. But being too firm comes with the risk of having to push out deadlines and test the public’s patience.

“You can do it once,” he said, as Mr. Cuomo and others have done. “But you begin to lose if you do that two or three times.”

Governors said they had become acutely aware of the dilemmas they face.

In his appearance on CNN, Mr. Hogan was shown footage of a long line winding around a supermarket in a Maryland suburb of Washington where free food was being handed out. The video was an unsettling avatar of the economic damage wrought by the virus. He said he shared in the frustration over the economy, but he also noted that his state had not yet reached its peak in cases.

“My goal is to try to get us open as quickly as we possibly can,” he said, “but in a safe way.”